Request support form

We need a form to send by email the notifications received by phone calls. Please, see further explanations in the description. ## Deliverables We need a form to send by email the notifications received by phone calls. The fields, buttons and others are: 1. Logo. We will provide. 2. Type of message. Radio button with 2 options; Free - Support 3. SendTo. Field to fill in an email where to send the from once filled. The behavior of this field will be; In case of select 'Support' in the above field (point 2), the email will be fixed. In case of Free, it is a combo filled with the emails loaded from an .ini file so the user can select one of those emails. In case of new email, it is possible to introduce a new one by overwriting the combo box field. Each new valid email introduced and used, will be uploaded and saved to that .ini file for future use. 4. OW_Code. 5. Company. 6. NameSurname. 7. Login. 8. Email. 9. LandLinePhone. 10. Mobile. 11. Subject. 12. MoreInformation. 13. Submit button. The behavior of fields 4 to 10 will be as follows: In case of select 'Free' in field 2, they will be free, any information can be filled in. In case of select 'Support', the information will be loaded from a database in a READ-ONLY mode. A more detailed behavior of the fields is as follows: The OW_Code and Company fields; are loaded from a given table with a given (fixed) filter. If OW_Code is changed; the corresponding Company is matched and the opposite. The NameSurname is a simple concatenation of 3 text fields which will be filled from the database once the OW_Code/Company field are selected, and is a selection of a given table with a filter in the OW_Code/Company fields. The Login field is filter once NameSurname is selected. The Email, LandLinePhone and Mobile phone is the same as Login field; a filter in a given table once OW_Code/Company fields AND NameSurname fields are selected. However, in despite of OW_Code/Company, NameSurname and Login fields which can't be edited, all these fields (email, LandlinePhone and Mobile) can be changed to any other value but, they will not be updated to the database. All the fields are mandatory except 12. The email fields must be checked to be a well-formed email address. Once all fields are selected/filled in... the user can press the Submit button and it will produce the following: a. An email to the SendTo(3) field but using as Sender email the field Email(8) provided. The sender name will be the Login field(7). The Subject with a concatenation of field OW_Code(5) and field Subject(11). The body of the email with all fields ordered and its titles as per the above relation (4 to 12). b. A message box indicating the result of the Submission. The parameters to connect to the database will be in a .ini or any other file. The password to access the database will not be saved in the file, so, there must be a prompt at any moment to provide it. We are thinking in a kind of form done using Microsoft Infopath or similar... something very compatible in case of using VBA... PHP or ASP, despite they are widely recommended, due to the complexity to mount a web server, they are not welcome. The use of this form will be in a very small office where everybody have access to any file so the web distribution is not an advantage here. However, please, make your recommendations.